Yamaji Hirosuke, Kawafuji Souhei, Sano Masaya, Higashiya Shunichi, Kubo Motoki, Murakami Takashi, Kawamura Hiroshi, Murakami Masaaki, Kamikawa Shigeshi, Hirohata Satoshi, Kusachi Shozo
Heart Rhythm Center, Okayama Heart Clinic, Takeda 54-1, Naka-Ku, Okayama, 703-8251, Japan.
Division of Clinical Engineering, Okayama Heart Clinic, Takeda 54-1, Naka-Ku, Okayama, 703-8251, Japan.
J Interv Card Electrophysiol. 2025 Jun 3. doi: 10.1007/s10840-025-02084-x.
The effectiveness of a novel diamond tip temperature-controlled ablation (DTA) catheter for left atrial posterior wall isolation (LAPWI) remains unclear.
This study evaluated the efficacy and safety of the DTA catheter for LAPWI under electrogram (EGM) guidance.
This single-center observational study compared the first-pass LAPWI success rate among three groups: DTA with EGM guidance (n = 82), conventional irrigation catheter with EGM guidance (Irri with EGM guidance; n = 92), and Irri without EGM guidance (n = 93), using fixed energy parameters (30 W, 15-20 s).
DTA with EGM guidance had a significantly higher incidence of first-pass LAPWI success (93%, 76/82) than that of Irri without EGM guidance (54%; 50/93) (p < 0.001) and had a success rate comparable to that of the Irri with EGM guidance (97%; 89/92). Post hoc Bonferroni analysis demonstrated that the DTA with EGM guidance group had a significantly shorter radiofrequency-energy delivery duration (158 ± 63 s) than that of the Irri with EGM guidance group (229 ± 131 s; p < 0.0001) and the Irri without EGM guidance group (243 ± 185 s; p < 0.001). The DTA with EGM guidance group had a higher average RF power (45.1 ± 5.6 W) than the Irri with (31.2 ± 2.2 W; p < 0.0001) and without EGM guidance groups (28.0 ± 8.9 W; p < 0.001). No significant complications were observed.
The novel DTA catheter with EGM guidance achieved a high first-pass LAPWI success rate. The novel DTA catheter with short energy delivery and high average radiofrequency (RF) energy delivery under EGM guidance can be effectively applied in LAPWI.
一种新型的金刚石尖端温控消融（DTA）导管用于左心房后壁隔离（LAPWI）的有效性尚不清楚。
本研究评估了在体表心电图（EGM）引导下DTA导管用于LAPWI的有效性和安全性。
这项单中心观察性研究比较了三组首次LAPWI成功率：EGM引导下的DTA组（n = 82）、EGM引导下的传统灌注射频消融导管组（EGM引导下的Irri组；n = 92）和无EGM引导的Irri组（n = 93），使用固定能量参数（30W，15 - 20秒）。
EGM引导下的DTA组首次LAPWI成功率（93%，76/82）显著高于无EGM引导的Irri组（54%；50/93）（p < 0.001），且成功率与EGM引导下的Irri组（97%；89/92）相当。事后Bonferroni分析表明，EGM引导下的DTA组射频能量输送持续时间（158 ± 63秒）显著短于EGM引导下的Irri组（229 ± 131秒；p < 0.0001）和无EGM引导的Irri组（243 ± 185秒；p < 0.001）。EGM引导下的DTA组平均射频功率（45.1 ± 5.6W）高于EGM引导下的Irri组（31.2 ± 2.2W；p < 0.0001）和无EGM引导的Irri组（28.0 ± 8.9W；p < 0.001）。未观察到显著并发症。
EGM引导下的新型DTA导管首次LAPWI成功率高。EGM引导下能量输送时间短且平均射频能量输送高的新型DTA导管可有效应用于LAPWI。
